Delayed Surgical Fixation of Femur Fractures Is a Risk Factor for Pulmonary Failure Independent of Thoracic Trauma

Charash, William E.; Fabian, Timothy C.; Croce, Martin A.

doi:10.1097/00005373-199410000-00023

Cited by 179 publications

(63 citation statements)

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“…Several observational studies [1][2][3][4][5][6][7][8] and one randomized study 9 have suggested that early stabilization of major long-bone fracturesthose of the shaft of the femur being most common-is associated with clinical benefits in terms of reducing the incidence of pulmonary complications and mortality. Other studies have suggested that internal fixation of long-bone fractures, either with intramedullary nailing or plate osteosynthesis, may have potentially deleterious effects in the acute setting, when systemic hypoperfusion 10 and inflammation [11][12][13] may increase susceptibility to end-organ injury and increase morbidity.…”

mentioning

confidence: 99%

Delayed Internal Fixation of Femoral Shaft Fracture Reduces Mortality Among Patients with Multisystem Trauma

Morshed

Miclau

Bembom

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

126

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mentioning

confidence: 99%

Delayed Internal Fixation of Femoral Shaft Fracture Reduces Mortality Among Patients with Multisystem Trauma

Morshed

Miclau

Bembom

et al. 2009

The Journal of Bone and Joint Surgery-American Volume

126

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“…Pulmonary contusion, caused by a blunt chest trauma, is considered to be one of the most important risk factors for the eventual development of ARDS (Charash et al 1994). A systemic postinjury infl ammatory response (SIR) may, together with additional stress factors such as IMN, predispose polytraumatized patients to post-traumatic pulmonary complications (Cohn andZieg 1996, Giannoudis et al 1998).…”

Section: Discussionmentioning

confidence: 99%

Early intramedullary nailing of lower extremity fracture and respiratory function in polytraumatized patients with a chest injuryA retrospective study of 61 patients

Handolin

Pajarinen

Lassus

et al. 2004

Acta Orthopaedica Scandinavica

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Background The optimal treatment of diaphyseal fractures of the lower extremities in patients who also have serious chest injuries is not known.Patients and methods We retrospectively evaluated the effect of an early intramedullary nailing (IMN) of femur or tibia fractures on respiratory function in 61 consecutive polytraumatized patients with unilateral or bilateral pulmonary contusion (thoracic AIS ≥ 3) admitted to our trauma intensive care unit between January 2000 and June 2001. 27 patients had a diaphyseal fracture of at least one long bone of the lower extremity, which was treated with IMN within 24 hours of admission.Results We found no difference between patients with or without a lower extremity fracture regarding the length of ventilator treatment, oxygenation ratio (PaO 2 /FiO 2 ) or in the incidence of acute respiratory distress syndrome (ARDS), pneumonia, multi-organ failure or mortality.Interpretation In this retrospective study, IMN of a long bone fracture in a patient with multiple injuries and with a coexisting pulmonary contusion did not impair pulmonary function or outcome.

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“…The mean age of the patients was 46.9 years (range, 21-84 years), and the mean ISS was 21.5 (range, 5-50). There were 19 polytraumatized patients (ISS [ 18) [8,19,31,33].…”

Section: Methodsmentioning

confidence: 99%

Outcomes of Nonoperatively Treated Displaced Scapular Body Fractures

Dimitroulias

Molinero

Krenk

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Displaced scapular body fractures most commonly are treated conservatively. However there is conflicting evidence in the literature regarding the outcomes owing to retrospective design of studies, different classification systems, and diverse outcome tools. Questions/purposes The functional outcome after nonoperative management of displaced scapular body fractures was assessed by change in the DASH (Disability of Arm, Shoulder and Hand) score; (2) the radiographic outcome was assessed by the change of the glenopolar angle (GPA); and (3) associated scapular and extrascapular injuries that may affect outcome were identified. Patients and Methods Forty-nine consecutive patients were treated with early passive and active ROM exercises for a displaced scapular body fracture. We followed 32 of these patients (65.3%) for a minimum of 6 months (mean, 15 months; range, 6-33 months). Mean age of the patients was 46.9 years (range, 21-84 years) and the mean Injury Severity Score (ISS) was 21.5 (range, 5-50). Subjective functional results (DASH score) and radiographic assessment (fracture union, glenopolar angle) were measured.

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Delayed Surgical Fixation of Femur Fractures Is a Risk Factor for Pulmonary Failure Independent of Thoracic Trauma

Cited by 179 publications

References 0 publications

Delayed Internal Fixation of Femoral Shaft Fracture Reduces Mortality Among Patients with Multisystem Trauma

Delayed Internal Fixation of Femoral Shaft Fracture Reduces Mortality Among Patients with Multisystem Trauma

Early intramedullary nailing of lower extremity fracture and respiratory function in polytraumatized patients with a chest injuryA retrospective study of 61 patients

Outcomes of Nonoperatively Treated Displaced Scapular Body Fractures

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